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2017 ; 134
(2
): 187-205
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Interactions of pathological proteins in neurodegenerative diseases
#MMPMID28401333
Spires-Jones TL
; Attems J
; Thal DR
Acta Neuropathol
2017[Aug]; 134
(2
): 187-205
PMID28401333
show ga
Neurodegenerative diseases such as Alzheimer's disease (AD), frontotemporal lobar
degeneration (FTD), Lewy body disease (LBD), Parkinson's disease (PD), and
amyotrophic lateral sclerosis (ALS) have in common that protein aggregates
represent pathological hallmark lesions. Amyloid ?-protein, ?-protein,
?-synuclein, and TDP-43 are the most frequently aggregated proteins in these
disorders. Although they are assumed to form disease-characteristic aggregates,
such as amyloid plaques and neurofibrillary tangles in AD or Lewy bodies in
LBD/PD, they are not restricted to these clinical presentations. They also occur
in non-diseased individuals and can co-exist in the same brain without or with a
clinical picture of a distinct dementing or movement disorder. In this review, we
discuss the co-existence of these pathologies and potential additive effects in
the human brain as well as related functional findings on cross-seeding and
molecular interactions between these aggregates/proteins. We conclude that there
is evidence for interactions at the molecular level as well as for additive
effects on brain damage by multiple pathologies occurring in different
functionally important neurons. Based upon this information, we hypothesize a
cascade of events that may explain general mechanisms in the development of
neurodegenerative disorders: (1) distinct lesions are a prerequisite for the
development of a distinct disease (e.g., primary age-related tauopathy for AD),
(2) disease-specific pathogenic events further trigger the development of a
specific disease (e.g., A? aggregation in AD that exaggerate further A? and
AD-related ? pathology), (3) the symptomatic disease manifests, and (4)
neurodegenerative co-pathologies may be either purely coincidental or (more
likely) have influence on the disease development and/or its clinical
presentation.
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